Journal
JOURNAL OF CLINICAL MEDICINE
Volume 12, Issue 2, Pages -Publisher
MDPI
DOI: 10.3390/jcm12020578
Keywords
Leishmania; ruxolitinib; myelofibrosis; immune response; cytokines
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Ruxolitinib, a JAK1/2 inhibitor, has revolutionized the treatment of myelofibrosis by improving symptoms but also increasing the risk of immunosuppression-related infections. Limited information is available regarding parasitic infections, particularly leishmaniasis.
Ruxolitinib is a JAK1/2 inhibitor that has revolutionized the approach to myelofibrosis. On the one side, this drug can rapidly improve the symptoms related to the hematological disease; on the other side, the inhibition of JAK1/2 can lead to immunosuppression which may increase the risk of infections, due to a change in the cytokine balance in favor of anti-inflammatory cytokines, to direct inhibition of immune cells, and to the suppression in the production of specific antibodies. In this patient setting, much is known about possible viral and bacterial infections, while little is reported in the literature concerning parasitic infections, specifically leishmaniasis. Leishmania is a parasitic infection that can cause serious problems in immunosuppressed patients. The parasite can invade the bloodstream and cause a wide range of symptoms, including fever, weight loss, and anemia. In severe cases, it can lead to multi-organ failure and, rapidly, death. Early diagnosis and prompt treatment are essential especially for these patients, unable to respond adequately. In this case and the following review of the existing literature, the cytokine kinetics and the production of specific anti-Leishmania antibodies represent characteristic aspects capable of providing a more in-depth understanding of the mechanisms underlying these complex clinical cases in an immunocompromised patient.
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